Skip directly to search Skip directly to A to Z list Skip directly to page options Skip directly to site content

NIOSHTIC-2 Publications Search

Search Results

Pulmonary and allergy subspecialty care in adults with asthma. Treatment, use of services, and health outcomes.

Authors
Blanc-PD; Katz-PP; Henke-J; Smith-S; Yelin-EH
Source
West J Med 1997 Dec; 167(6):398-407
NIOSHTIC No.
20024644
Abstract
To study the relationship between physician subspecialty practice type and health measures in patients with adult asthma, we prospectively studied 601 adults with asthma. The subjects were recruited from a random sample of board-certified pulmonary or allergy internal medicine subspecialists practicing in northern California; 539 patients (90%) were restudied after 18 months. Structured telephone interviews were used to elicit demographics, clinical variables, and measures of asthma severity, asthma-specific quality of life, and physical function status. At baseline and follow-up, 283 subjects (53%) reported their principal asthma care provider type as a pulmonary specialist throughout and 150 (28%) as an allergy specialist throughout, 53 (10%) switched provider type during follow-up, and 53 (10%) reported that their principal asthma care physician was from neither subspecialist group. Taking into account illness severity and other demographic and clinical covariates, the group whose principal asthma care came from an allergy subspecialist was more likely than the pulmonary specialist-care group to report possessing a peak expiratory flow rate meter (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.8 to 4.6) and less likely to be receiving high-dose inhaled steroids (OR, 0.3; 95% CI, 0.1 to 0.6). Taking into account demographic and clinical covariates, allergists' care was related to worse subject-reported asthma-specific quality of life (P = 0.02), but not to statistically increased risk of hospitalization, decreased physical function, or an increased number of reported health-related restricted-activity days. We observed subject-reported specialist variation in management and health outcomes among adults with asthma not accounted for by differing disease severity or other clinical and demographic variables.
Keywords
Bronchial-asthma; Psychological-factors; Demographic-characteristics; Smoking; Age-factors; Sex-factors; Racial-factors; Respiratory-system-disorders; Pulmonary-system-disorders; Allergies
Contact
Paul Blanc, MD, MSPH, Box 0924, UCSF, San Francisco, CA 94143-0924
CODEN
WJMDA2
Publication Date
19971201
Document Type
Journal Article
Funding Amount
372965
Funding Type
Grant
Fiscal Year
1998
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-003480
Issue of Publication
6
ISSN
0093-0415
Priority Area
Research Tools and Approaches: Social and Economic Consequences
Source Name
Western Journal of Medicine
State
CA
Performing Organization
University of California, Cardiovascular Research Institute, San Francisco, California
TOP